What You Need to Know About the Rise of Value-Based Care
The United States spent $10,348 per person for health care in 2016, according to the Centers for Medicare and Medicaid Services. That’s a staggering number, especially when comparing to others across the globe. Legislation has recently shifted the focus from cutting the budget for care where it’s needed most to taking a good, hard look at the health-care delivery system and making it more efficient.
There has been a shift in process on the horizon that can change the way your facility provides services: value-based care. This newer concept comes as an alternative to the treatment option of fee-for-service (FFS), which is guided by volume and dollars, not patient care, ensuring more expensive, frequent treatment options. With value-based care, your facility will be incentivized for more proactive care, allowing the focus to be on quality instead of quantity. This can drastically lighten the workload as it is aimed to keep readmission rates down, and will be a welcome change from the healthcare industry’s pressure of high volumes.
Is your facility thinking of making the switch to value-based care?
While America has focused on treating illness in the past, the shift is gearing towards prevention and keeping people healthier for longer. Value-based care will ensure your facility is reimbursed for maintaining the well-being of your patients by treating them before the onset of illness and more intensive care is required. This allows your facility to reap the benefits of the reduction in expenditures. The movement is all about controlling costs, only ordering necessary tests, disease education and health coaching, and making quality the highest priority; but, it won’t happen overnight.
If your hospital or treatment center is in the process of or considering to make the switch, HealthCatalyst names three challenges you should be aware of to ensure a successful transition:
- Keeping track of two systems: Many systems, such as Medicare, are still reimbursing patients using FFS, so it’s important for facilities to think of their performances on two very different levels depending on the situation.
- Measuring up: Since the incentives and penalties rely on the quality of care instead of quantity, it’s important to figure out the best way to measure practitioner performance for each patient population, which calls for a complicated analytics model.
- Worth the wait: It’s estimated that the change from FFS to value-based care will take many years to fully transition to where everyone is on the same page. In the meantime, there may be revenue drops during this period as FFS phases out, so it’s important to ensure margins can be optimized as much as possible.
The Department of Health and Human Services reported that 20% of Medicare payments were made through a value-based model in 2015, and Medicare beneficiaries’ hospital readmission rates were down by eight percent, which is a step in the right direction for patients’ long-term health.
As the evidence comes in to affirm this system’s success, it is important to stay educated and updated about all the research being done, as well as tried and true methods from hospitals and other facilities which are serving as trailblazers to this slow-and-steady process. There are many different value-based care models to keep in mind, and it’s important to understand which one would best serve your patients.
The top four models include the Accountable Care Organization (ACO), Patient-Centered Medical Home (PCMH), Pay-for-performance, and Bundled Payments. With the right model, an efficient workflow, strong patient relationships, and the analytic technology to make it all work, your facility can be a part of the healthcare revolution that’s sweeping the country.
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Has your workplace embraced or shied away from this change? What are your thoughts on value-based care? Share with us on our Facebook page or leave us your thoughts in the comment section below!